Total nail excisions with matricectomies have been done for many years by various disciplines in the medical sciences. Most common conditions that warrant such a procedure have classically been deformity due to onychomycoses and severe onychodystrophies, all conditions representing chronic reoccurrence. The techniques in performing the radical excision of nails has been varied between surgical excision of the matrix and excision of the nail plate to chemosurgical destruction, and most recently, fulgeration by laser of the matrix cells. All surgical procedures have generally accomplished their aims, that is to destroy the nail so there is no regrowth. Unfortunately, this has left the patient with a dilemma: the eradication of the condition (whatever it may have been) at the expense of cosmetic consideration, as well as some degree of discomfort, though not "pain" per se.
Since our society holds beauty and physical perfection in such high regard, the lack of a nail on either a foot or hand can represent a significant detriment to one's perception of physical well being. The method to date in dealing with this problem for those so concerned has been to minimize the untoward cosmetic effect by coating the cornifed nail bed with nail polish or, in the case of feet, foregoing the use of various shoewear which calls attention to the appearance of the toes. Specifically with the feet an additional problem is identified relative to cosmetic needs. Dress shoewear for females is generally designed to enhance and to accentuate the female physique; shoewear plays a very important role in one's overall appearance. Many styles of shoes strive to appeal to that which is aesthetic over that which is functional. Since female feet are thus more exposed than corresponding male feet in terms of shoewear, this problem can be identified more acutely with the female population.
Attempts have been made to provide an artificial nail for cosmetic purposes. Rosen, in 1970, described the use of a monomer-polymer prosthetic nail plate temporarily attached with gum spirits to the underlying healed nail bed. The nail plate was custom designed on a model which was then used on the actual toe. Many doctors have since recommended the use of commercial artificial finger nails, adapted to toes and attached to the surrounding skin by varying methods of adhesion.